Signs and symptoms: A 73 year-old Caucasian woman presented with a 20 year history of violaceous masses of the left periocular area and left chest that have waxed and waned. These lesions were asymptomatic. 10 years ago, the lesions were biopsied and diagnosed as a low-grade B cell lymphoma without systemic involvement, and no chemotherapy was indicated at that time. Over the years, the lesions continued to wax and wane, but recently, the lesions have gotten larger.

CHIEF COMPLAINT: A patient presents with a pruritic rash in the axillae.

CLINICAL HISTORY:

Signs and symptoms: A 70 year old female presents with a several month history of hyperpigmented pruritic lesions in bilateral axillae.

Previous Treatment: None.

Other information: Her past medical history is significant for arthritis, thyroid disease, diabetes, and hypertension. Her medications include pioglitazone, calcium, valsartan and a thyroid medication. She denies any changes in her soap or laundry detergent. The patient’s lesions persist despite switching brand of deodorant. She denies dryer sheet usage but uses a scented fabric softener. She also has no known drug allergies.

CHIEF COMPLAINT: NC is a 19 yr old Hispanic male with a seven year history of a persistent rash. The lesions began on his proximal extremities and increased in number and size over time. The lesions began one year after allogeneic bone marrow transplant for acute myelogenous leukemia. However, he stated that he was not taking any immunosuppressants when the rash started. The lesions were occasionally pruritic and unresponsive to super-high potency topical steroids.

CHIEF COMPLAINT: We present a 25 y/o female with a history of adolescent onset rash and progressively worsening symptoms.

CLINICAL HISTORY:

Signs and symptoms: Upon review of history, patient admitted to recurrent episodes of headaches, fainting spells, flushing, pruritus, palpitations, wheezing, abdominal pain, and vomiting within the last year. Her skin lesions periodically become raised, erythematous, and pruritic, which are exacerbated with “asthma attacks.” Exercise and naprosyn worsen her symptoms and induce acute attacks. Neurocardiogenic syncope was also noted on medical history.